| NPI | 1407309610 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DANIEL R KELLEHER Owner 203-616-5234 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084P0804X Psychiatry & Neurology Child & Adolescent Psychiatry |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology Psychiatry |
| Enumeration Date | 2016-07-25 |
| Last Update Date | 2023-05-05 |